'It's time to let him go'
"We wish Madiba a speedy recovery, but I think what is important is that his family must release him.
"You [Madiba] have been coming to the hospital too many times. Quite clearly you are not well and there is a possibility you might not be well again.
"The family must release him so that God may have his own way. They must release him spiritually and put their faith in the hands of God. Once the family releases him, the people of South Africa will follow. We will say thank you, God, you have given us this man, and we will release him too."
These are the words uttered by Andrew Mlangeni, a longtime friend of Nelson Mandela, upon hearing the news that the statesman had been hospitalised for a fourth time since December.
Mlangeni's impassioned plea is likely to elicit dismay among Mandela family members and the ANC government, who have cautioned calm each time the former president has been hospitalised.
Mandela was rushed to hospital at 1.30am yesterday after experiencing "breathing difficulty".
He was accompanied by his wife, Graça Machel, who cancelled a trip to London on Thursday because of concerns over Mandela's health. She was meant to speak at a hunger summit convened by British Prime Minister David Cameron, who tweeted yesterday: "My thoughts are with Nelson Mandela, who is in hospital in South Africa."
The presidency said yesterday that Madiba was being treated for a recurring lung infection.
"The doctors realised the condition had gone worse. Doctors are there all the time. Remember, he's been under home-based high care since the last time he was hospitalised," said presidential spokesman Mac Maharaj.
In December, Mandela spent three weeks in hospital for a lung infection.
In March, he returned there for "a routine" check-up while doctors conducted tests. He was discharged the next day and returned to his Johannesburg home.
By the end of that month, he was readmitted and treated for pneumonia.
Maharaj said yesterday that Mandela's condition was serious. "I questioned the doctors. I said how is he? They said: 'Look, yes, he is able to breathe on his own. Be concerned, but don't be hysterical about it. Also don't tell the public that he is getting better [for now]'," Maharaj said.
Professor Keertan Dheda, head of pulmonology at the University of Cape Town and Groote Schuur Hospital, said that pneumonia, in layman's terms, referred to infectious or inflammatory material in the air sacs of the lung.
"When you get an infection such as pneumonia, those air sacs become filled with bacteria and lots of inflammatory cells, like soldiers that fight infections. The air sacs fill up with fluid ... so the property of air diffusing through these air sacs into the blood is marginalised. Oxygen levels may drop in the blood, you tend to breathe more rapidly and, of course, you start coughing up this inflammatory material."
Pneumonia can have several causes, including bacteria such as pneumococcus, tuberculosis, an obstruction in the airway, or even cancer.
"Pneumonia is more common in the elderly. The lung defences are less robust in elderly patients and they are more likely to be hospitalised," said Dheda. "The immune system is also less robust and able to respond to infection."
The other reason why a patient's lung immunity, besides old age, would be marginalised was if they had previously had tuberculosis, which can cause damage to the lungs or airways. Mandela has been treated for the disease in the past.
Mandela's grandson Mandla, who usually comments on his grandfather's health problems, yesterday declined to talk.
"We don't have a comment as a family as yet. We will let you know when we are ready to speak," he said.
One of Mandela's other grandsons, Ndaba, said: "Please give us our space. It's better that way. We are all going through the same thing - we don't know what will happen, we are hoping for the best."
A senior government official, who described Mandela's condition as "bad", said the former president was taken to hospital after experiencing breathing difficulties following a week of intense observation by doctors.
Residents in Mandela's birthplace, Qunu, said yesterday that they were praying for his recovery. Many inhabitants only heard of Mandela's hospitalisation from journalists who had gone to the Eastern Cape village.
Jonathan Krexe, 85, one of Mandela's neighbours, said: "This is the man who brought all this happiness and a better life for all of us. We only have prayers for him for a speedy recovery. Madiba brought about a better life to all of us.
"He is the people's man, humble and caring. If it was my own wish, I would be prepared to die in his place. We still need Madiba."
Zibela Mandela, 19, said he prayed for the "speedy recovery of my great-grandfather".
"We are nothing without him in Qunu," he said. "We still need him."
The president of the Congress of Traditional Leaders of South Africa, Nkso Phathekile Holomisa, who is also an aba-Thembu chief, said: "We appeal to our ancestors and God that he recovers. We know that he is old and cannot live forever, but we still need him."
Political parties and trade unions yesterday wished the statesman a speedy recovery.
ANC spokesman Jackson Mthembu said: "We send to him our well wishes for a speedy recovery so that he may soon be discharged to return to the care and comfort of his home."
DA national spokesman Mmusi Maimane said the party was saddened by the news of Mandela's return to hospital. "Nelson Mandela is a father to South Africa and South Africans. Every time he is admitted to hospital we feel saddened along with the rest of our country."